The metabolic syndrome - What is it and how should it be managed?

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Nilsson , P M , Tuomilehto , J & Ryden , L 2019 , ' The metabolic syndrome - What is it and how should it be managed? ' , European journal of preventive cardiology , vol. 26 , no. 2_SUPPL , pp. 33-46 .

Title: The metabolic syndrome - What is it and how should it be managed?
Author: Nilsson, Peter M.; Tuomilehto, Jaakko; Ryden, Lars
Contributor organization: Clinicum
Department of Public Health
University of Helsinki
Date: 2019-12
Language: eng
Number of pages: 14
Belongs to series: European journal of preventive cardiology
ISSN: 2047-4873
Abstract: A cluster of metabolic factors have been merged into an entity named the metabolic syndrome. Although the characteristics of this syndrome have varied over time the presently used definition was established in 2009. The presence of three abnormal findings out of five components qualifies a person for the metabolic syndrome: elevated waist circumference, elevated triglycerides, reduced high-density lipoprotein cholesterol, elevated blood pressure and elevated fasting plasma glucose. Cut points have been defined for all components apart from waist circumference, for which national or regional values are used. The metabolic syndrome predicts cardiovascular disease and type 2 diabetes. This associated risk does not exceed its components whereof elevated blood pressure is the most frequent. A successful management should, however, address all factors involved. The management is always based on healthy lifestyle choices but has not infrequently to be supported by pharmacological treatment, especially blood pressure lowering drugs. The metabolic syndrome is a useful example of the importance of multiple targets for preventive interventions. To be successful management has to be individualized not the least when it comes to pharmacological therapy. Frail elderly people should not be over-treated. Knowledge transfer of how risk factors act should be accompanied by continuous trust building and motivation. In complex situations with a mix of biological risk factors, adverse social conditions and unhealthy lifestyle, everything cannot be changed at once. It is better to aim for small steps that are lasting than large, unsustainable steps with relapses to unhealthy behaviours. A person with the metabolic syndrome will always be afflicted by its components, which is the reason that management has to be sustained over a very long time. This review summarizes the knowledge on the metabolic syndrome and its management according to present state of the art.
Subject: Cardiovascular risk
risk for type 2 diabetes
plasma glucose
blood pressure
waist circumference
blood lipids
dietary habits
physical activity
3121 General medicine, internal medicine and other clinical medicine
Peer reviewed: Yes
Rights: unspecified
Usage restriction: openAccess
Self-archived version: publishedVersion

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